Provider Demographics
NPI:1649650300
Name:VELA, ALYSON RENEE (BSW)
Entity type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:RENEE
Last Name:VELA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17320 QUAIL CREEK DR.
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456
Mailing Address - Country:US
Mailing Address - Phone:616-502-6585
Mailing Address - Fax:
Practice Address - Street 1:1256 WALKER AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504
Practice Address - Country:US
Practice Address - Phone:616-235-2910
Practice Address - Fax:616-235-1436
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker